THEORIES AND MODELS IN NURSING MANAGEMENT

SEMINAR ON
THEORIES AND MODELS
OF MANAGEMENT
Liji C Maria
2nd MSc Nursing
Govt. College of Nursing Kottayam

MANAGEMENT THEORIES/
APPROACHES
1. CLASSICAL
APPROACH
2. NEOCLASSICAL APPROACH
3. MODERN APPROACH

1. THE CLASSICAL
APPROACH
Classical school of thought began around 1900
and continued into the 1920s. It focuses on
efficiency. It includes:
1.Scientific management theories
2. Bureaucracy or organizational theories
3. Administrative theories.

Classical approach Cont…….
1.Scientific Management Theories
Scientific management focuses on the "one best
way" to do a job. The theories brought out
principles of management are:
• Frederick Taylor's principles of management
• Time and Motion Studies
• The Gantt chart.

Scientific Management Theories
cont….
1.Frederick Taylor's Principles of
Management
In 1911, published Principles of Scientific
Management in which he proposed to increase
worker productivity.

Scientific Management Theories
cont….
The principles developed by F.W. Taylor
• Development and application of scientific
methods rather than rule of thumb methods
• Scientific procedure for selection, training and
development of employees
• Harmony; cooperation and equal division of
responsibility between management and
employees
• Both management and employees should try to
achieve maximum output in place of restricted
output.

2.Time and Motion Studies Frank ,
Lillian and Gilbreth
Frank and Lillian Gilbreth
• They believed it was possible to design work
methods whose times could be estimated in
advance.
• This enabled the manager to break down a job
into it’s component parts and streamline the
process.
• Gilbreths developed the laws of motion economy,
which involved 22 principles dealing with the use
of the human body; the workplace arrangement;
and tools and equipment design.

3.The Gantt Chart by Henry Gantt
• Henry L Gantt (1861 1919) developed planning
and control techniques using a simple graphic
bar chart, the Gantt chart to display
relationships between planned and completed
work on one axis and elapsed time on the other
axis.
• He focused motivational schemes, emphasizing
the greater effectiveness of rewards for good
work (rather than penalties for poor work).

2.Bureaucracy/Organizational Theory
Bureaucratic management relies on a rational
set of structuring guidelines, such as rules and
procedures, hierarchy, and a clear division of
labor.

cont….

cont….
1.Max Weber Theory of Bureaucracy
Principles to guide the management of an
organization:
• Qualification-based hiring – Hire employees
based on their educational qualification or
technical training.
• Merit-based promotion – Manager decide
on promotions and base their decisions on
experience or achievement.

cont….
• Chain of command – Organizations must have a
structure wherein each position reports and is
accountable to a higher position. Also, create a
complaints process to protect the rights of
workers in lower positions.
• Division of labour – Responsibilities, tasks, and
authority is equally divided and clearly defined.
• Impartiality – Regardless of the position or status
of an employee, all rules and regulations must
apply to all members of the organization.

Bureaucracy/Organizational Theory
cont….
• Recording in writing – Record every single
administrative act, decision, rule or procedure
in writing.
• Owners are not managers – The owners of a
company should not manage it. bureaucratic
management relies on a rational set of
structuring guidelines, such as rules and
procedures, hierarchy, and a clear division of
labor.

3. General Administrative
Management Theories
• It focuses on managing the organization as a
whole instead of managing the individuals.
• Main thinkers of this schools are Fayol and
Mary Parker Follett.

1.Henri Fayol's Principles of
Management
He divided all activities of an industrial enterprise in the
following six groups:
• Technical activities pertaining to production
• Commercial activities (buying/selling)
• Financial activities pertaining to the optimum
utilization of capital
• Accounting activities (final accounts, costs, statistics,
etc.)
• Security-related activities (protecting the premises)
• Managerial activities

2.Luther Gulick and Lyndall
Urwick's Theory of Administrative
Management
• Luther Halsey Gulick (1892-1993)
expanded on the works of Henri Fayol
to build foundation for management
theory.
• He identified the executive functions
and coined seven activity acronym,
POSDCORB.

3. Administrative Management
Theories cont….
• Gulick added the concept of span of control,
and also recommended unity of command.
• His major contribution was the theory of
departmentalization. He identified 4Ps:
purpose (function), process, persons
(clientele), and place as the bases for dividing
the work and based on this departments can be
created.

Administrative Management
Theories cont ….
Lyndall Urwick(1891-1983) born in Britain in 1891.
• Urwick defined organization as determining
activities that are necessary for a purpose.
• He fostered modern thought about the
management functions of planning, organizing,
controlling, and developing general managerial
guidelines and generated a list of ten general
principles for improving managerial effectiveness
as of Fayol.

3.Mary Parker Follett and
Management Theory
• According to parker, integration is a method of
settling conflicts instead of compromise or
domination. The bases of integration are:
 to bring the differences into the open instead
of suppressing them; consider the demands of
both sides involved in the conflict; and
anticipation of conflict and building up of
attitudes in the people

2. NEOCLASSICAL
APPROACH
It has been referred to as the neoclassical school
because it was initially a reaction to the
shortcomings of the classical approaches to
management. It includes management thoughts
of;
Human relations school
Human resources school

Neoclassical approach cont…..
Human Relations Management Theories
• Behavioral or human relations management
emerged in the 1920s and dealt with the
human aspects of organizations.
• Elton Mayo and Chester Barnard are thinkers
of this school.

Human Relations Management
Theories cont……
Elton Mayo's Hawthorne Effect
• George Elton Mayo (1880-1949 ) Identified the
Hawthorne Effect or the bias that occurs when
people know that they are being studied or
observed.

Theories cont…..
Chester Barnard Theories
The Theory of authority and the theory of
incentives. Both are seen in the context of a
communication system that are based in seven
essential rules.

Theories cont….
1 The channels of communication should be definite
2 Everyone should know the channels of communication
3 Everyone should have access to the formal channels of
communication
4 Lines of communication should be as short and as direct
as possible
5 Competence of persons serving as communication
centers should be adequate
6 The line of communication should not be interrupted
when organization is functioning
7 Every communication should be authenticated

Human resource theories
Motivational theories
• Content theories of motivation
• Process theories of motivation.

Neoclassical theory cont……
Content Theories of Motivation
These theories are based on human needs and
motivational derives.
• Maslow's hierarchy of needs theory
• Herzberg's Motivation hygiene theory and job
enrichment
• McGregor Theory X and Theory Y
• Theory Z . 3 need theory
• Alderfer's E-R-G Theory

Content theories of motivation cont…
• 1. Physiological Needs: Food, Water, Shelter,
Sleep, Excretion, Sexual activity etc.
• 2. Safety Needs: a sense of security of the
self, laws, order, policies, job-safety,
financial ,health and well being ,etc.

• 3. Belongingness and Love Needs: Strong
Bonds, Love relationships, friendship ,
intimacy ,family etc.
• 4. Esteem Needs: self-confidence, respect,
good reputation, etc.
• 5. Self-Actualization needs: morality,
spontaneity, and acceptance.

1970's adapted
• Cognitive needs - knowledge, meaning, etc.
• Aesthetic needs - appreciation and search for
beauty, balance,
In 1990 adapted
• Transcendence needs- Helping others to
achieve self actualization.

Herzberg's Motivation-Hygiene theory and job
enrichment
• Frederick Herzberg (1923-2000) was the first
to show that satisfaction and dissatisfaction
at work nearly always arose from different
factors.

• Satisfiers, which perform the role of motivators
in jobs or the factors involved in doing the job,
are: achievement, recognition, works itself,
responsibility, advancement and growth.
• Hygienic factors or Dissatisfiers are the factors
which define the job context include working
conditions, organization policy and
administration, salary, supervision, interpersonal
relations that have little or no relationship to the
motivation of job related behavior.

• Job enrichment is a technique used by the
managers to maximize the internal motivation
among employees to work. It is a production
and profit oriented way of managing.
• This technique is important to eliminate
problems like high turnover, absenteeism,
grievances and high training cost.

Douglas McGregor theory X and theory Y

Theory Z:
Theory Z is often referred to as the 'Japanese'
management style, developed by William Ouchi, is
professor of management at Los Angeles.
Theory Z is a combination of all that's best about
theory Y and modem Japanese management,
which places a large amount of freedom and trust
with workers with the assumption that workers
have a strong loyalty and interest in team-working
and the organization.

Characteristics of Z theory are:
• Job security
• Collective responsibility
• Informal control with formal measures
• Collective decision making
• Slow evaluation and promotion
• Moderately specialized careers
• Concern for employee including family.

Achievement-motivational or Three
Needs Theory
David Clarence McClelland (1917-98),

Process Theories of Motivation
Behaviour Modification Model
• Organization behaviour modification model is
based on principles of law of effect.
• According to this theory responses that
produce a satisfying or pleasant state of affairs
in a particular situation are more likely to
occur again in a similar situation.

Neoclassical approach cont……
Skinner's S-R theory.
• This model is also evolved from the work of
B.F. Skinner, who was an American
behaviorist. Reinforcement is the key element
in Skinner's S-R theory.

cont….
• Behaviour is encouraged primarily through positive
reinforcement that provides a favorable consequence
and encourages repetition of behaviour.
• Rewards may not be expensive but just recognition for
good work, giving certificate, verbal appreciation,
social gathering, can help to produce positive
reinforcement among employees to bring desired
results.
• In order to that there should be correct shaping of
desired behaviour and withholding of significant
positive consequences

cont…..
Locke's Goal Setting Theory
Edwin A. Locke was a pioneer on goal setting and
motivation theory.
five basic principles of this theory:
Clear goals
Challenge
Commitment
Task complexity
Performance monitoring and feedback..

cont….
Expectancy (Three Factors) Theory
Expectancy theory is developed by Victor H,
Vroom.

It states that motivation is determined by the
outcomes that people expect as a result of their
actions on the job. It is the combination of effort
(which arises from motivation), performance,
and outcomes.
Essentially it holds that people will be
motivated when expect that they will be able to
achieve what they want from their jobs.

cont…
Equity Theory
• Equity theory is developed by J Stacey Adams,
John Stacey Adams in 1963.
• This process theory of motivation focuses on
workers' perceptions of the fairness of their
work outcomes and inputs and states that
positive outcomes and high levels of motivation
can be expected only when employees perceive
their treatment to be fair.

3.Modern Approach
A. Leadership Theories
Great Man and Trait Theories
Leadership Continuum Behaviour Model
Managerial Grid model
Leader-Member Exchange Theory
Burns' Leadership Theories
Emotional Intelligence Leadership Theory

Path-Goal Theory
Situational Leadership Theory

3.Modern Approach cont…..
B. Decision Making Models
Herbert A. Simon' Decision Making Model
• According to Simon, decision making is a core
of administrative actions that fills the gap
between principles and practice and
organization as a structure of decision makers.
• The decisions are required to make at all the
levels of the organization.

C. System theory
• Managers find optimal solutions to
management problems by using scientific
analysis, which is closely associated with the
systems approach to management.

3.Modern Approach cont….
System theory

DISCUSSION TOPIC
APPLICATION OF THEORIES AND
MODELS IN HOSPITAL MANAGEMENT

MODELS IN MANAGEMENT
Models are graphic or symbolic representations
of phenomena that objectify and present certain
perspectives or points of view about nature or
function or both. Models may be theoretical or
empirical.

MODELS IN MANAGEMENT
1. NORMATIVE MODEL
2. DESCRIPTIVE MODEL
3. DECISION TREE MODEL
4. STRATEGIC MODEL
5. NURSING PROCESS MODEL
6. INTUTIVE DECISION MAKING MODEL
7. ECONOMICAL MODEL
8. MORAL MODEL
9. ETHICAL DECISION MAKING MODEL
10. BOUNDED RATIONALITY MODEL
11. PROBLEM SOLVING MODEL

Models in management cont…….
1. Normative Model
Nine steps are identified in this model.
• Predetermined goal (or) desired value
• Define and analyze problem
• Identify all alternatives
• Evaluate each alternative
• Rank order of alternatives
• Select maximizing alternative
• Implement decision
• Follow-up

2.Descriptive model
Herbert Simon developed the descriptive model
based on the assumption that the decision
maker is a rational person looking for acceptable
solutions based on known information.

Steps in the descriptive model.
• Establish a satisfactory or acceptable goal
• Define the subjective perceptions of the problem
• Identify acceptable alternatives
• Evaluate each alternative in terms of its ability to
solve the problem satisfactorily.
• Select a satisfactory alternative
• Implement the decision
• Follow-up.

Decision tree model cont…..
• Magee and Brown made decision trees as starting
with a basic problem and using branches to
represent event. The number of branches
corresponds to the number of identified
alternatives.
• Every path through the tree corresponds to a
possible sequence of actions and events, each
with it’s own distinct consequences. Probabilities
of both positive and negative consequences of
each action and event are estimated and
recorded on the appropriate branch.

• Additional options and consequences of each
action event sequence can be depicted on the
decision tree.
• Normal analysis of the tree is conducted by
computing predicted consequences of all
event (the right hand edge of the tree),
substituting that value for the actual event
with the best expected consequences.

Models cont…..
4. Strategic model
• The three crucial elements in decision making
are represented by three interconnected
circles.
• Identify the problem
• Developing a solution that are reasonable
alternatives
• Selecting a single best solution.

Models cont…..
5. Nursing Process Model
• The nursing process provides problem solving
approach and decision making.
• As a decision making model, the nursing
process has a strength that is feed back
mechanisms. When the decision point has
been identified, initial decision making occurs
and continues throughout the process by
using a feedback mechanism.

Models cont…..
6. Intuitive decision making model
• Romiszowski built on the nursing process
in creating the intuitive decision making
model.
• In this model, the decision maker consciously
incorporates recall all cumulative knowledge
that comes from education, both formal and
informal as well as experience, in planning the
decision.

Models cont…..
7. Economical model
Steps of this model.
• Discover the symptoms of the problem or difficulty.
• Determine the goal to be achieved or define the problem to the
solved.
• Develop a criterion against which alternative solution can be
evaluated.
• Identify the alternative course of action.
• Consider the consequences of each alternative as well as the
likelihood of occurrence of each.
• Choose the beast alternative by comparing the consequences of
each alternative.
• Act or implement the decision.

Models cont…..
8. Moral Model
• According to Crisham Moral model representing:
• M - Massage the dilemma, collect data about the ethical problem
and who shows be involved in the decision making process.
• 0 - Outline options, identify alternatives and analyze the causes and
consequences.
• R - Review criteria and resolve, weigh the options against the values
of those involved in the decision. This may be done through a
weighting system.
• A – A firm position and act, develop strategy for implementation.
• L - Look back, evaluate the decision making.

Models cont…..
9. Ethical decision making model
According to Murphy and Murphy
The steps of this model include:
• Identify the problem
• Determine why the problem is an ethical one .
• Identify the people involved in the ultimate decision.
• Define the role of decision maker.
• Consider the short and lmg term consequences of each alternative.
• Make the decision.
• Compare the decision with the philosophy of the decision makers ethics.
• Follow-up on the results of the decision in order to establish a baseline for
future
• decision making.

Models cont…..
10. Bounded rationality model
Managerial decision making is assumed to be
rational in the managers make consistent, value
maximizing choices within specified constraints.
A decision maker who was perfectly rational
would be fully objective and logical.

Models cont…..
11. Problem solving model
Problem solving and decision making are vital
abilities for nursing practice.
Vroom and Jago decision-making model .

Problem solving model cont…..
• This model is rule-based decision tree to guide leaders
about when and when not to include subordinate
participation in decision making. It considers 12
contingency variables:
• Importance of the decision.
• Importance of obtaining follower commitment to the
decision.
• Whether the leader has sufficient information to make
a good decision.
• How well structured the problem is.
• Whether an autocratic decision would receive follower
commitment.

Problem solving model cont…..
Whether followers "buy into" the organization's goals.
Whether there is likely to be conflict among followers over
solution alternatives.
Whether followers have the necessary information to make a
good decision.
Time constraints on the leader that may limit follower
involvement.
Whether costs to bring geographically dispersed members
together is justified.
Importance to the leader of minimizing the time it takes to make
the decision.
Importance of using participation as a tool for developing
follower decision skills.

APPLICATION OF THEORIES AND
MODELS IN HOSPITAL
MANAGEMENT

APPLICATION of theories and models
in Hospital management
• Management theories used to build organizations and
guide them toward their goals and are grounded in
reality.
• A theory is a conceptual framework for organizing
knowledge
• It provides blueprint for action
• It helps in planning, organizing, staffing, directing and
controlling of the organization
• It helps in scientific validation

THEORIES AND MODELS IN NURSING MANAGEMENT

THEORIES AND MODELS IN NURSING MANAGEMENT

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